Advertisement

Drug Safety

, Volume 32, Issue 1, pp 1–18 | Cite as

Vision Disorders and Phosphodiesterase Type 5 Inhibitors

A Review of the Evidence to Date
  • Alan M. LatiesEmail author
Review Article

Abstract

Phosphodiesterase type 5 (PDE-5) inhibitors (sildenafil, vardenafil and tadalafil) have been in widespread use for the safe and effective treatment of erectile dysfunction (ED) for nearly a decade. During that time, a relatively small number of patients have experienced adverse visual events, including nonarteritic anterior ischaemic optic neuropathy (NAION). In this article, post-marketing reports of adverse visual events along with other relevant literature on ocular safety related to PDE-5 inhibitor use are reviewed. Although a relatively small number of cases have been reported with a possible temporal association with PDE-5 inhibitor use, it has not been possible to conclude whether these events are coincidental or whether they are associated with effects of PDE-5 inhibitors on ocular circulation or on other structures of the eye. A careful review of pooled data from clinical trials for all three PDE-5 inhibitors, which contain well documented information about the dose and duration of exposure to the drug for a large number of patients, yields no evidence for an increased risk of NAION or other adverse ocular events associated with PDE-5 inhibitor use. However, the inherent limitations in interpreting results from clinical trials and potentially incomplete information from post-marketing surveillance preclude a definitive declaration that ocular safety will not be a concern for some patients with ED and comorbid disease states. Despite the absence of a proven link between PDE-5 use and serious ocular disorders, physicians should continue to advise patients to stop use of a PDE-5 inhibitor and seek immediate medical attention in the event of a sudden loss of vision as a safety measure.

Keywords

Erectile Dysfunction Retinal Nerve Fibre Layer Obstructive Sleep Apnoea Tadalafil Retinal Nerve Fibre Layer Thickness 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgements

Editorial support was provided by Donald G. Buerk, PhD, of Complete Healthcare Communications, Inc., and was funded by Pfizer Inc.

Alan Laties received grant support from, was a study investigator for, and is a consultant to Pfizer Inc.

References

  1. 1.
    Selvin E, Burnett AL, Platz EA. Prevalence and risk factors for erectile dysfunction in the US. Am J Med 2007; 120(2): 151–7PubMedCrossRefGoogle Scholar
  2. 2.
    Feldman HA, Goldstein I, Hatzichristou DG, et al. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol 1994; 151: 54–61 15PubMedGoogle Scholar
  3. 3.
    Aytac IA, McKinlay JB, Krane RJ. The likely worldwide increase in erectile dysfunction between 1995 and 2025 and some possible policy consequences. BJU Int 1999; 84(1): 50–6CrossRefGoogle Scholar
  4. 4.
    Feldman HA, Johannes CB, Derby CA, et al. Erectile dysfunction and coronary risk factors: prospective results from the Massachusetts Male Aging Study. Prev Med 2000; 30(4): 328–38PubMedCrossRefGoogle Scholar
  5. 5.
    Seftel AD, Sun P, Swindle R. The prevalence of hypertension, hyperlipidemia, diabetes mellitus and depression in men with erectile dysfunction. J Urol 2004; 171(6 Pt 1): 2341–5PubMedCrossRefGoogle Scholar
  6. 6.
    Bacon CG, Mittleman MA, Kawachi I, et al. A prospective study of risk factors for erectile dysfunction. J Urol 2006; 176(1): 217–21PubMedCrossRefGoogle Scholar
  7. 7.
    Millett C, Wen LM, Rissel C, et al. Smoking and erectile dysfunction: findings from a representative sample of Australian men. Tob Control 2006; 15(2): 136–9PubMedCrossRefGoogle Scholar
  8. 8.
    Kupelian V, Link CL, McKinlay JB. Association between smoking, passive smoking, and erectile dysfunction: results from the Boston Area Community Health (BACH) Survey. Eur Urol 2007; 52(2): 416–22PubMedCrossRefGoogle Scholar
  9. 9.
    Ponholzer A, Temml C, Mock K, et al. Prevalence and risk factors for erectile dysfunction in 2869 men using a validated questionnaire. Eur Urol 2005; 47(1): 80–5; discussion 85–6PubMedCrossRefGoogle Scholar
  10. 10.
    Riedner CE, Rhoden EL, Ribeiro EP, et al. Central obesity is an independent predictor of erectile dysfunction in older men. J Urol 2006; 176(4 Pt 1): 1519–23PubMedCrossRefGoogle Scholar
  11. 11.
    Kupelian V, Shabsigh R, Araujo AB, et al. Erectile dysfunction as a predictor of the metabolic syndrome in aging men: results from the Massachusetts Male Aging Study. J Urol 2006; 176(1): 222–6PubMedCrossRefGoogle Scholar
  12. 12.
    Thompson IM, Tangen CM, Goodman PJ, et al. Erectile dysfunction and subsequent cardiovascular disease. JAMA 2005; 294: 2996–3002PubMedCrossRefGoogle Scholar
  13. 13.
    Andersson KE. Pharmacology of penile erection. Pharmacol Rev 2001; 53(3): 417–50PubMedGoogle Scholar
  14. 14.
    Laties AM, Sharlip I. Ocular safety in patients using sildenafil citrate therapy for erectile dysfunction. J Sex Med 2006; 3(1): 12–27PubMedCrossRefGoogle Scholar
  15. 15.
    Salonia A, Rigatti P, Montorsi F. Sildenafil in erectile dysfunction: a critical review. Curr Med Res Opin 2003; 19(4): 241–62PubMedCrossRefGoogle Scholar
  16. ]16.
    IMS Midas 2007 report; Verispan 2007 report. New York: Pfizer Inc., 2008. (Data on file)Google Scholar
  17. 17.
    Viagras R. Full prescribing information sildenafil citrate. New York: Pfizer Inc., 2008Google Scholar
  18. 18.
    Jackson G, Montorsi P, Cheitlin MD. Cardiovascular safety of sildenafil citrate (Viagra®): an updated perspective. Urology 2006; 68 Suppl. 3A: 47–60PubMedCrossRefGoogle Scholar
  19. 19.
    Kostis JB, Jackson G, Rosen R, et al. Sexual dysfunction and cardiac risk: the Second Princeton Consensus Conference. Am J Cardiol 2005; 96: 313–21PubMedCrossRefGoogle Scholar
  20. 20.
    Jackson G, Rosen RC, Kloner RA, et al. The Second Princeton Consensus on sexual dysfunction and cardiac risk: new guidelines for sexual medicine. J Sex Med 2006; 3(1): 28–36; discussion 36PubMedCrossRefGoogle Scholar
  21. 21.
    LEVITRA®. Full prescribing information vardenafil. West Haven (CT): Bayer Pharmaceuticals Corporation, 2008Google Scholar
  22. 22.
    CIALIS®. Full prescribing information tadalafil. Indianapolis (IN): Lilly ICOS, LLC, 2008Google Scholar
  23. 23.
    Gresser U, Gleiter CH. Erectile dysfunction: comparison of efficacy and side effects of the PDE-5 inhibitors sildenafil, vardenafil and tadalafil: review of the literature. Eur J Med Res 2002; 7(10): 435–46PubMedGoogle Scholar
  24. 24.
    Brock GB, McMahon CG, Chen KK, et al. Efficacy and safety of tadalafil for the treatment of erectile dysfunction: results of integrated analyses. J Urol 2002; 168(4 Pt 1): 1332–6PubMedGoogle Scholar
  25. 25.
    Hellstrom WJ, Gittelman M, Karlin G, et al. Vardenafil for treatment of men with erectile dysfunction: efficacy and safety in a randomized, double-blind, placebo-controlled trial. J Androl 2002; 23(6): 763–71PubMedGoogle Scholar
  26. 26.
    Hellstrom WJ, Gittelman M, Karlin G, et al. Sustained efficacy and tolerability of vardenafil, a highly potent selective phosphodiesterase type 5 inhibitor, in men with erectile dysfunction: results of a randomized, double-blind, 26-week placebo-controlled pivotal trial. Urology 2003; 61 (4 Suppl. 1): 8–14PubMedCrossRefGoogle Scholar
  27. 27.
    Blonde L. Sildenafil citrate for erectile dysfunction in men with diabetes and cardiovascular risk factors: a retrospective analysis of pooled data from placebo-controlled trials. Curr Med Res Opin 2006; 22(11): 2111–20PubMedCrossRefGoogle Scholar
  28. 28.
    Mittleman MA, Maclure M, Glasser DB. Evaluation of acute risk for myocardial infarction in men treated with sildenafil citrate. Am J Cardiol 2005; 96(3): 443–46PubMedCrossRefGoogle Scholar
  29. 29.
    Mittleman MA, Glasser DB, Orazem J. Clinical trials of sildenafil citrate (Viagra) demonstrate no increase in risk of myocardial infarction and cardiovascular death compared with placebo. Int J Clin Pract 2003; 57(7): 597–600PubMedGoogle Scholar
  30. 30.
    Kloner RA, Jackson G, Hutter AM, et al. Cardiovascular safety update of tadalafil: retrospective analysis of data from placebo-controlled and open-label clinical trials of tadalafil with as needed, three times-per-week or once-a-day dosing. Am J Cardiol 2006; 97(12): 1778–84PubMedCrossRefGoogle Scholar
  31. 31.
    Goldman SA, Kennedy DL, Graham DJ, et al. The clinical impact of adverse event reporting [online]. Available from URL: http://www.fda.gov/medwatch/articles/medcont/postmkt.htm [Accessed 2007 Jun 19]
  32. 32.
    Cheng E. Real-life safety and efficacy of vardenafil in the treatment of erectile dysfunction-results from 30,010 U.S. patients. J Sex Med 2007; 4(2): 432–9PubMedCrossRefGoogle Scholar
  33. 33.
    van Ahlen H, Zumbe J, Stauch K, et al. The real-life safety and efficacy of vardenafil: an international post-marketing surveillance study: results from 29 358 German patients. J Int Med Res 2005; 33(3): 337–48PubMedGoogle Scholar
  34. 34.
    Kim CM, Kim YS, Sunwoo S, et al. Post-marketing surveillance study of the efficacy and safety of vardenafil among patients with erectile dysfunction in primary care. Int J Impot Res 2007; 19(4): 393–7PubMedCrossRefGoogle Scholar
  35. 35.
    Hazell L, Boshier A, Harris S, et al. An observational cohort study investigating the cardiovascular safety of tadalafil when prescribed in primary care in England: mortality due to ischaemic heart disease. BJU Int 2007; 99(2): 387–93PubMedCrossRefGoogle Scholar
  36. 36.
    Toda N, Nakanishi-Toda M. Nitric oxide: ocular blood flow, glaucoma, and diabetic retinopathy. Prog Retin Eye Res 2007; 26(3): 205–38 16PubMedCrossRefGoogle Scholar
  37. 37.
    Conti M, Beavo J. Biochemistry and physiology of cyclic nucleotide phosphodiesterases: essential components in cyclic nucleotide signaling. Annu Rev Biochem 2007; 76: 481–511PubMedCrossRefGoogle Scholar
  38. 38.
    Cote RH. Characteristics of photoreceptor PDE (PDE6): similarities and differences to PDE5. Int J Impot Res 2004; 16 Suppl. 1: S28–33PubMedCrossRefGoogle Scholar
  39. 39.
    Zhang K. From better erection to better sex: Viagra updates 2005. Zhonghua Nan Ke Xue 2005; 11: 796–9PubMedGoogle Scholar
  40. 40.
    Laties A, Ellis P, Koppiker N, et al. Visual function testing in patients and healthy volunteers receiving Viagra [abstract]. Ophthalmic Res 1998; 30 Suppl. 1: 177Google Scholar
  41. 41.
    Laties A, Ellis P, Mollon JD. The effects of sildenafil citrate (Viagra) on color discrimination in volunteers and patients with erectile dysfunction [abstract]. Invest Ophthalmol Vis Sci 1999; 40 (4 Suppl.): S693Google Scholar
  42. 42.
    Laties AM, Zrenner E. Viagra® (sildenafil citrate) and ophthalmology. Prog Retin Eye Res 2002; 21: 485–506PubMedCrossRefGoogle Scholar
  43. 43.
    Osterloh I, Gillies H, Siegel R, et al. Efficacy and safety of Viagra® (sildenafil citrate). Fourth Biennial Congress of the European Society for Sexual and Impotence Research; 2001 Sep 30–Oct 3; RomeGoogle Scholar
  44. 44.
    Jägle H, Jägle C, Serey L, et al. Visual short-term effects of Viagra: double-blind study in healthy young subjects. Am J Ophthalmol 2004; 137(5): 842–9PubMedCrossRefGoogle Scholar
  45. 45.
    Bollinger K, Lee MS. Recurrent visual field defect and ischemic optic neuropathy associated with tadalafil rechallenge. Arch Ophthalmol 2005; 123(3): 400–1PubMedCrossRefGoogle Scholar
  46. 46.
    Govier F, Potempa AJ, Kaufman J, et al. A multicenter, randomized, double-blind, crossover study of patient preference for tadalafil 20 mg or sildenafil citrate 50 mg during initiation of treatment for erectile dysfunction. Clin Ther 2003; 25(11): 2709–23PubMedCrossRefGoogle Scholar
  47. 47.
    Hayreh SS. The 1994 Von Sallman Lecture: the optic nerve head circulation in health and disease. Exp Eye Res 1995; 61(3): 259–72PubMedCrossRefGoogle Scholar
  48. 48.
    Stefansson E, Pedersen DB, Jensen PK, et al. Optic nerve oxygenation. Prog Retin Eye Res 2005; 24(3): 307–32PubMedCrossRefGoogle Scholar
  49. 49.
    Arnold AC. Pathogenesis of nonarteritic anterior ischemic optic neuropathy. J Neuroophthalmol 2003; 23(2): 157–63PubMedCrossRefGoogle Scholar
  50. 50.
    Polak K, Wimpissinger B, Berisha F, et al. Effects of sildenafil on retinal blood flow and flicker-induced retinal vasodilatation in healthy subjects. Invest Ophthalmol Vis Sci 2003; 44(11): 4872–6PubMedCrossRefGoogle Scholar
  51. 51.
    Grunwald JE, Siu KK, Jacob SS, et al. Effect of sildenafil citrate (Viagra) on the ocular circulation. Am J Ophthamol 2001; 131: 751–5CrossRefGoogle Scholar
  52. 52.
    Foresta C, Caretta N, Zuccarello D, et al. Expression of the PDE5 enzyme on human retinal tissue: new aspects of PDE5 inhibitors ocular side effects. Eye 2008; 22(1): 144–9PubMedCrossRefGoogle Scholar
  53. 53.
    Grunwald JE, Jacob SS, Siu K, et al. Acute effects of sildenafil citrate (Viagra®) on intraocular pressure in open-angle glaucoma. Am J Ophthalmol 2001; 132(6): 872–4PubMedCrossRefGoogle Scholar
  54. 54.
    Metelitsina TI, Grunwald JE, DuPont JC, et al. Effect of Viagra on the foveolar choroidal circulation of AMD patients. Exp Eye Res 2005; 81(2): 159–64PubMedCrossRefGoogle Scholar
  55. 55.
    Metelitsina TI, Grunwald JE, DuPont JC, et al. Effect of Viagra on retinal vein diameter in AMD patients. Exp Eye Res 2006; 83(1): 128–32PubMedCrossRefGoogle Scholar
  56. 56.
    Grunwald JE, Koppiker NP, Hodges M. Visual adverse events in patients with eye disorders who received sildenafil for the treatment of erectile dysfunction [abstract]. Invest Ophthalmol Vis Sci 1999; 40 (4 Suppl.): S767Google Scholar
  57. 57.
    Eke T, Spry PGD, Cioffi GA, et al. Short term effects of sildenafil (Viagra) in eyes of glaucoma patients [abstract]. Invest Ophthalmol Vis Sci 2001; 42: S421Google Scholar
  58. 58.
    Kurtulan E, Gulcu A, Secil M, et al. Effects of sildenafil on ocular perfusion demonstrated by color Doppler ultrasonography. Int J Impot Res 2004; 16(3): 244–8PubMedCrossRefGoogle Scholar
  59. 59.
    Dundar SO, Dayanir Y, Topaloglu A, et al. Effect of sildenafil on ocular hemodynamics in 3 months regular use. Int J Impot Res 2006; 18(3): 282–6PubMedCrossRefGoogle Scholar
  60. 60.
    Koksal M, Ozdemir H, Kargi S, et al. The effects of sildenafil on ocular blood flow. Acta Ophthalmol Scand 2005; 83(3): 355–9PubMedCrossRefGoogle Scholar
  61. 61.
    Rucker JC, Biousse V, Newman NJ. Ischemic optic neuropathies. Curr Opin Neurol 2004; 17(1): 27–35PubMedCrossRefGoogle Scholar
  62. 62.
    Hattenhauer MG, Leavitt JA, Hodge DO, et al. Incidence of nonarteritic anterior ischemic optic neuropathy. Am J Ophthalmol 1997; 123: 103–7PubMedGoogle Scholar
  63. 63.
    Johnson LN, Arnold AC. Incidence of nonarteritic and arteritic anterior ischemic optic neuropathy: population-based study in the state of Missouri and Los Angeles County, California. J Neuroophthalmol 1994; 14(1): 38–44PubMedCrossRefGoogle Scholar
  64. 64.
    Xu L, Wang Y, Jonas JB. Incidence of nonarteritic anterior ischemic optic neuropathy in adult Chinese: the Beijing Eye Study. Eur J Ophthalmol 2007; 17(3): 459–60PubMedGoogle Scholar
  65. 65.
    Gorkin L, Hvidsten K, Sobel RE, et al. Sildenafil citrate use and the incidence of nonarteritic anterior ischemic optic neuropathy. Int J Clin Pract 2006; 60(4): 500–3PubMedCrossRefGoogle Scholar
  66. 66.
    Hayreh SS, Zimmerman MB. Nonarteritic anterior ischemic optic neuropathy: natural history of visual outcome. Ophthalmology 2008; 115(2): 298–305.e2PubMedCrossRefGoogle Scholar
  67. 67.
    Tomsak R. PDE5 inhibitors and permanent visual loss. Int J Impot Res 2005; 17(6): 547–9PubMedCrossRefGoogle Scholar
  68. 68.
    Beck R, Servais G, Hayreh S. Anterior ischemic optic neuropathy: IX. Cup-to-disc ratio and its role in pathogenesis. Ophthalmology 1987; 94: 1503–8PubMedGoogle Scholar
  69. 69.
    Jonas J, Laties AM. Clinical assessment of disk at risk [abstract]. Acta Ophthalmologica 2008; 86 Suppl. 243: 5125Google Scholar
  70. 70.
    Hayreh SS, Zimmerman MB. Optic disc edema in nonarteritic anterior ischemic optic neuropathy. Graefes Arch Clin Exp Ophthalmol 2007; 245(8): 1107–21PubMedCrossRefGoogle Scholar
  71. 71.
    Contreras I, Noval S, Rebolleda G, et al. Follow-up of nonarteritic anterior ischemic optic neuropathy with optical coherence tomography. Ophthalmology 2007; 114(12): 2338–44PubMedCrossRefGoogle Scholar
  72. 72.
    Deleon-Ortega J, Carroll KE, Arthur SN, et al. Correlations between retinal nerve fiber layer and visual field in eyes with nonarteritic anterior ischemic optic neuropathy. Am J Ophthalmol 2007; 143(2): 288–94PubMedCrossRefGoogle Scholar
  73. 73.
    Tesser RA, Niendorf ER, Levin LA. The morphology of an infarct in nonarteritic anterior ischemic optic neuropathy. Ophthalmology 2003; 110(10): 2031–5 17PubMedCrossRefGoogle Scholar
  74. 74.
    Newman NJ, Scherer R, Langenberg P, et al. The fellow eye in NAION: report from the ischemic optic neuropathy decompression trial follow-up study. Am J Ophthalmol 2002; 134(3): 317–28PubMedCrossRefGoogle Scholar
  75. 75.
    Collignon-Robe NJ, Feke GT, Rizzo 3rd JF. Optic nerve head circulation in nonarteritic anterior ischemic optic neuropathy and optic neuritis. Ophthalmology 2004; 111(9): 1663–72PubMedCrossRefGoogle Scholar
  76. 76.
    Hayreh SS, Zimmerman MB. Incipient nonarteritic anterior ischemic optic neuropathy. Ophthalmology 2007; 114(9): 1763–72PubMedCrossRefGoogle Scholar
  77. 77.
    Bella AJ, Brant WO, Lue TF, et al. Non-arteritic anterior ischemic optic neuropathy (NAION) and phosphodiesterase type-5 inhibitors. Can J Urol 2006; 13(5): 3233–8PubMedGoogle Scholar
  78. 78.
    Hayreh SS. Erectile dysfunction drugs and non-arteritic anterior ischemic optic neuropathy: is there a cause and effect relationship? J Neuroophthalmol 2005; 25(4): 295–8PubMedCrossRefGoogle Scholar
  79. 79.
    Nagy V, Steiber Z, Takacs L, et al. Trombophilic screening for nonarteritic anterior ischemic optic neuropathy. Graefes Arch Clin Exp Ophthalmol 2006; 244(1): 3–8PubMedCrossRefGoogle Scholar
  80. 80.
    Pinna A, Solinas G, Masia C, et al. Glucose-6-phosphate dehydrogenase (G6PD) deficiency in nonarteritic anterior ischemic optic neuropathy in a Sardinian population, Italy. Invest Ophthalmol Vis Sci 2008; 49(4): 1328–32PubMedCrossRefGoogle Scholar
  81. 81.
    Hayreh SS, Jonas JB, Zimmerman MB. Nonarteritic anterior ischemic optic neuropathy and tobacco smoking. Ophthalmology 2007; 114(4): 804–9PubMedCrossRefGoogle Scholar
  82. 82.
    Teloken PE, Smith EB, Lodowsky C, et al. Defining association between sleep apnea syndrome and erectile dysfunction. Urology 2006; 67(5): 1033–7PubMedCrossRefGoogle Scholar
  83. 83.
    Mojon DS, Hedges 3rd TR, Ehrenberg B, et al. Association between sleep apnea syndrome and nonarteritic anterior ischemic optic neuropathy. Arch Ophthalmol 2002; 120(5): 601–5PubMedGoogle Scholar
  84. 84.
    Palombi K, Renard E, Levy P, et al. Non-arteritic anterior ischaemic optic neuropathy is nearly systematically associated with obstructive sleep apnoea. Br J Ophthalmol 2006; 90(7): 879–82PubMedCrossRefGoogle Scholar
  85. 85.
    Behbehani R, Mathews MK, Sergott RC, et al. Nonarteritic anterior ischemic optic neuropathy in patients with sleep apnea while being treated with continuous positive airway pressure. Am J Ophthalmol 2005; 139(3): 518–21PubMedCrossRefGoogle Scholar
  86. 86.
    Dhillon S, Shapiro CM, Flanagan J. Sleep-disordered breathing and effects on ocular health. Can J Ophthalmol 2007; 42(2): 238–43PubMedCrossRefGoogle Scholar
  87. 87.
    Pack AI. Advances in sleep-disordered breathing. Am J Respir Crit Care Med 2006; 173(1): 7–15PubMedCrossRefGoogle Scholar
  88. 88.
    Egan R, Pomeranz H. Sildenafil (Viagra) associated anterior ischemic optic neuropathy. Arch Ophthalmol 2000; 118(2): 291–2PubMedGoogle Scholar
  89. 89.
    Pomeranz HD, Bhavsar AR. Nonarteritic ischemic optic neuropathy developing soon after use of sildenafil (Viagra): a report of seven new cases. J Neuroophthalmol 2005; 25(1): 9–13PubMedCrossRefGoogle Scholar
  90. 90.
    Pomeranz HD, Smith KH, Hart WM, et al. Sildenafil-associated nonarteritic anterior ischemic optic neuropathy. Ophthalmology 2002; 109(3): 584–7PubMedCrossRefGoogle Scholar
  91. 91.
    Cunningham AV, Smith KH. Anterior ischemic optic neuropathy associated with Viagra. J Neuroophthalmol 2001; 21(1): 22–5PubMedCrossRefGoogle Scholar
  92. 92.
    Boshier A, Pambakian N, Shakir SA. A case of nonarteritic ischemic optic neuropathy (NAION) in a male patient taking sildenafil. Int J Clin Pharmacol Ther 2002; 40(9): 422–3PubMedGoogle Scholar
  93. 93.
    Cockerham KP. Drugs (Viagra), sex and blindness-technology for good & bad. The Bulletin 2003 Aug; 380Google Scholar
  94. 94.
    Dheer S, Rekhi GS, Merlyn S. Sildenafil associated anterior ischaemic optic neuropathy. J Assoc Physicians India 2002; 50: 265PubMedGoogle Scholar
  95. 95.
    Gruhn N, Fledelius HC. Unilateral optic neuropathy associated with sildenafil intake. Acta Ophthalmol Scand 2005; 83(1): 131–2PubMedCrossRefGoogle Scholar
  96. 96.
    Sinha S, Pathak-Ray V, Ahluwalia H, et al. Viagra or what? Eye 2004; 18(4): 446–8PubMedCrossRefGoogle Scholar
  97. 97.
    Gedik S, Yilmaz G, Akova YA. Sildenafil-associated consecutive nonarteritic anterior ischaemic optic neuropathy, cilioretinal artery occlusion, and central retinal vein occlusion in a haemodialysis patient. Eye 2007; 21(1): 129–30PubMedCrossRefGoogle Scholar
  98. 98.
    Peter NM, Singh MV, Fox PD. Tadalafil-associated anterior ischaemic optic neuropathy. Eye 2005; 19(6): 715–7PubMedCrossRefGoogle Scholar
  99. 99.
    Escaravage Jr GK, Wright Jr JD, Givre SJ. Tadalafil associated with anterior ischemic optic neuropathy. Arch Ophthalmol 2005; 123(3): 399–400PubMedCrossRefGoogle Scholar
  100. 100.
    McGwin Jr G, Vaphiades MS, Hall TA, et al. Non-arteritic anterior ischaemic optic neuropathy and the treatment of erectile dysfunction. Br J Ophthalmol 2006; 90(2): 154–7PubMedCrossRefGoogle Scholar
  101. 101.
    Sobel RE, Cappelleri JC. NAION and treatment of erectile dysfunction: reply from Pfizer [letter]. Br J Ophthalmol 2006; 90(7): 927PubMedCrossRefGoogle Scholar
  102. 102.
    Margo CE, French DD. Ischemic optic neuropathy in male veterans prescribed phosphodiesterase-5 inhibitors. Am J Ophthalmol 2007; 143(3): 538–9PubMedCrossRefGoogle Scholar
  103. 103.
    Ware JH. The limitations of risk factors as prognostic tools. N Engl J Med 2006; 355(25): 2615–7PubMedCrossRefGoogle Scholar
  104. 104.
    Maclure M, Mittleman MA. Should we use a case-crossover design? Annu Rev Public Health 2000; 21: 193–221PubMedCrossRefGoogle Scholar
  105. 105.
    Sowka JW, Neiberg MN, Vollmer LA. Optic atrophy after sildenafil use. Optometry 2007; 78(3): 122–8PubMedCrossRefGoogle Scholar
  106. 106.
    Ramasamy B, Rowe F, Nayak H, et al. Acute angle-closure glaucoma following sildenafil citrate-aided sexual intercourse. Acta Ophthalmol Scand 2007; 85(2): 229–30PubMedCrossRefGoogle Scholar
  107. 107.
    McGee HT, Egan RA, Clark WM. Visual field defect and intracerebral hemorrhage associated with use of vardenafil (Levitra). Neurology 2005; 64(6): 1095–6PubMedCrossRefGoogle Scholar
  108. 108.
    Tripathi A, O’Donnell NP. Branch retinal artery occlusion; another complication of sildenafil. Br J Ophthalmol 2000; 84(8): 934–5PubMedCrossRefGoogle Scholar
  109. 109.
    Bertolucci A, Latkany RA, Gentile RC, et al. Hemi-retinal artery occlusion associated with sexual activity and sildenafil citrate (Viagra). Acta Ophthalmol Scand 2003; 81(2): 198–200PubMedCrossRefGoogle Scholar
  110. 110.
    Bujarborua D, Chatterjee S, Choudhury A, et al. Fluorescein angiographic features of asymptomatic eyes in 18 central serous chorioretinopathy. Retina 2005; 25(4): 422–9PubMedCrossRefGoogle Scholar
  111. 111.
    van Velthoven ME, Verbraak FD, Garcia PM, et al. Evaluation of central serous retinopathy with en face optical coherence tomography. Br J Ophthalmol 2005; 89(11): 1483–8PubMedCrossRefGoogle Scholar
  112. 112.
    Tittl MK, Spaide RF, Wong D, et al. Systemic findings associated with central serous chorioretinopathy. Am J Ophthalmol 1999; 128(1): 63–8PubMedCrossRefGoogle Scholar
  113. 113.
    Yannuzzi LA. Type A behavior and central serous chorioretinopathy. Trans Am Ophthalmol Soc 1986; 84: 799–845PubMedGoogle Scholar
  114. 114.
    Murata M, Ideta H, Kawasaki T, et al. A case of central serous chorioretinopathy after sildenafil (Viagra). Kyushu Ganka Gakkai 2000; 42: 727–30Google Scholar
  115. 115.
    Allibhai ZA, Gale JS, Sheidow TS. Central serous chorioretinopathy in a patient taking sildenafil citrate. Ophthalmic Surg Lasers Imaging 2004; 35(2): 165–7PubMedGoogle Scholar
  116. 116.
    Quiram P, Dumars S, Parwar B, et al. Viagra-associated serous macular detachment. Graefes Arch Clin Exp Ophthalmol 2005; 243(4): 339–44PubMedCrossRefGoogle Scholar

Copyright information

© Adis Data Information BV 2008

Authors and Affiliations

  1. 1.Department of OphthalmologyScheie Eye Institute, University of Pennsylvania School of MedicinePhiladelphiaUSA

Personalised recommendations